Public health surveillance involves the continuous collection and analysis of health data to support public health practice. It serves as an early warning system and allows priorities to be set through monitoring health problems. Various organizations, including hospitals, schools, and health departments collect surveillance data. This data can then be used by public health officials to understand disease distribution and spread, identify potential cases, and estimate disease magnitude. Nurses can access surveillance data from sources like the CDC and WHO to inform their practice and identify health risks and needs in their communities.

1. Public Health Surveillance
Locally, State-wide, Nationally
and Globally
Catherine Johnson, PhD, CRNP, FNP, PNP
Duquesne University School of Nursing

2. What is Public Health Surveillance?
 Continuous, systematic collection, analysis and interpretation of
health-related data needed for the planning, implementation, and
evaluation of public health practice.
 Can serve as an early warning system for impending public health
emergencies;
 Documents the impact of an intervention and/or tracks progress
towards specified goals
 Monitors the epidemiology of health problems, to allow priorities to
be set and to inform public health policy and strategies.

3. Who Collects the Data?
Hospital
DATA
BASE
Private
Practices
Schools Health
Department
Clinics
Laboratory
Employers

4. The Uses of Public Health Data
• Determine the geographical distribution of illness in the
community
• Identify potential cases for contact information and clinical
history
• Estimate the magnitude of the disease spread
• Monitor the spread of reportable diseases and detect epidemics
Pennsylvania Dept. of Health, “ NEDSS new user guide”, version 15.1, 01/07/2013

5. Allegheny County Health Department
What information is available?
 Plan for a Healthier Allegheny County
 http://www.achd.net/pha/index.html
 Infectious Disease
 http://www.achd.net/infectd/index.html
 Illness & Fact Sheets
 http://www.achd.net/factsheet/index.html
 Office of Epidemiology and Biostatistics (OEB)
 http://www.achd.net/biostats/

6. Pennsylvania Department of Health
What information is available?
 My Records
 http://www.health.pa.gov/MyRecords/Pages/default.aspx#.ViQ_wfPD-M8
 My Health
 http://www.health.pa.gov/My%20Health/Pages/default.aspx#.ViQ_9vPD-M8
 Health Statistics
 http://www.statistics.health.pa.gov/Pages/default.aspx#.ViRAPvPD-M-

7. NEDSS
 What is NEDSS?
 National Electronic Disease Surveillance System
 The data collection system used to improve the timeliness,
completeness and accuracy of surveillance data.
 Used in State Health Departments for mandatory disease reporting
 PA Reportable Diseases:
http://www.achd.net/infectd/pubs/pdf/Reportable_Diseases_&_C
onditions_in_Allegheny_County.pdf
 Pennsylvania Dept. of Health, “ NEDSS new user guide”, version 15.1, 01/07/2013

8. CDC Priorities
Improve Health Security at Home and
Around the World
Prevent Leading Causes of Illness, Injury,
Disability, and Death
Strengthen Public Health–Healthcare
Collaboration

9. Health Indicator Warehouse
Access to high quality data improves understanding of a community’s health
status and determinants, and facilitates the prioritization of interventions. The
purpose of the HIW is to:
• Provide a single, user-friendly, source for national, state, and community
health indicators
• Meet needs of multiple population health initiatives
• Facilitate harmonization of indicators across initiatives
• Link indicators with evidence-based interventions
• Serve as the data hub for the HHS Community Health Data Initiative, a flagship
HHS open government initiative to release data; encourage innovative
application development; and catalyze change to improve community health

10. The Global Disease Detection Program (GDD) is CDC’s principal and
most visible program for developing and strengthening global
capacity to rapidly detect, accurately identify, and promptly contain
emerging infectious disease and bioterrorist threats that occur
internationally.

11. Global Health: CDC and WHO
 Key strategy areas include:
Surveillance system strengthening,
Laboratory strengthening,
Training and capacity development,
Monitoring and evaluation, and
Advocacy.

12. Example Global Outbreaks in Recent Years: Zika
History of Zika
 Zika virus was first discovered in 1947 and is named after the Zika
Forest in Uganda.
 In 1952, the first human cases of Zika were detected and since then,
outbreaks of Zika have been reported in tropical Africa, Southeast
Asia, and the Pacific Islands.
 Zika outbreaks have probably occurred in many locations. Before
2007, at least 14 cases of Zika had been documented, although other
cases were likely to have occurred and were not reported.
 Because the symptoms of Zika are similar to those of many other
diseases, many cases may not have been recognized.

13. How Zika Spreads
 Zika can be transmitted through
 Mosquito bites
 From a pregnant woman to her fetus
 Sex
 Blood transfusion (very likely but not confirmed)
CDC: https://www.cdc.gov/zika/about/overview.html

14. Zika Symptoms
Many people infected with Zika virus won’t have symptoms or will only have
mild symptoms.
The most common symptoms of Zika are
 Fever
 Rash
 Joint pain
 Conjunctivitis (red eyes)
Other symptoms include:
 Muscle pain
 Headache
Symptoms can last for several days to a week. People usually don’t get sick
enough to go to the hospital, and they very rarely die of Zika. Once a person
has been infected with Zika, they are likely to be protected from future
infections

15. Risks Association with Zika
 Zika infection during pregnancy can cause a birth defect of the brain
called microcephaly and other severe fetal brain defects.
 Other problems have been detected among fetuses and infants
infected with Zika virus before birth, such as defects of the eye,
hearing deficits, and impaired growth.
 There have also been increased reports of Guillain-Barré syndrome, an
uncommon sickness of the nervous system, in areas affected by Zika.

16. State Public Health Response
 State Department of Health have established prevention programs for
pregnant women.
 PA Board of Health have established distribution centers for Zika
Prevention Kits for Pregnant Women:
 Distribution Centers:
http://www.health.pa.gov/My%20Health/Diseases%20and%20Conditions/U-
Z/Zikavirus/Pages/ZikaPreventionKits.aspx#.V9q3ffPD_c
 Handouts
http://www.health.pa.gov/My%20Health/Diseases%20and%20Conditions/U-
Z/Zikavirus/Documents/20695%20ZIKA%20print%20materials%20V8.pdf

17. How you can use public health data to
enhance your nursing practice.
 Population data is available at the global, national, state and local
level.
 This data can assist you identifying risk factors for yourself, family,
patients and community.
 As a student you can explore where this information can be found and
begin to include it in your assessments and interactions with patients
and communities.

18. Identifying Your Communities Public
Health and Disease Data
 Start by identifying international health concerns and risk factor at the World
Health Organization http://www.who.int/en/
 Note Outbreaks and Emergencies and Mosquito-borne diseases.
 Then focus on US national trends, public health concerns and disease
prevalence at http://www.cdc.gov/
 Choose one or more diseases that affect you or your family listed under DISEASES
and CONDITIONS tab
 For example select Heart Disease and then explore the Heart Disease data including
maps, and prevalence associated with race, gender and age

19. Identifying Your Communities Public
Health and Disease Data
Pennsylvania Department of Health:
http://www.health.pa.gov/Pages/default.aspx#.V9q7QvPD_cu
Explore current trends, emergencies and conditions
Select Health Statistics Tab (right side of PA BON Home Page:
http://www.statistics.health.pa.gov/Pages/default.aspx#.V9q7E_PD_cv
Explore this site and then select EDDIE under QUICK STATS tab:
http://www.statistics.health.pa.gov/StatisticalResources/EDDIE/Pages/EDDIE.as
px#.V9q7wvPD_cs
Explore the EDDIE system to create data tables for various health related data
from each county in state including breast cancer incidence

20. Identifying Your Communities Public
Health and Disease Data
To provide you with a snapshot of your local community go to your County Health
Department website
For Example: Allegheny County Department of Health Disparities Dashboard
http://www.achd.net/aci/index.html?hcn=DisparitiesDashboard
 County Health Rankings and Roadmaps provide a snapshot of your
communities health rankings including Length of Life; Quality of Life;
Additional Health Outcomes; Clinical Care (including mammography
screening) Social and Economic Factor; Physical Environment
 http://www.countyhealthrankings.org/

21. Summary
 Public Health Surveillance is a critical component of the health care system in
the US as well as worldwide.
 Information is available regarding the health status and diseases and
conditions of individuals and communities through local& state health
departments as well as National (CDC) and Global (WHO) agencies.
 Nurses provide important information to these agencies regarding reportable
diseases as well as have the opportunity to stay informed through their
websites regarding prevalence of overall health, diseases and conditions and
emergencies within their communities.

22. Thank you!

23. Bibliography
 “Public Health Surveillance” Source: World Health
Organization,
www.who.int/topics/public_health_surveillance/en/ ,
Retrieved 10/15/2014
 Pennsylvania Dept. of Health, “ NEDSS new user
guide”, version 15.1, 01/07/2013
 “Case Definition” Source: Centers for Disease Control,
http://www.cdc.gov/vhf/ebola, retrieved
10/15/2014.